Adjustable pressure ippb ventilator

ABSTRACT

A breathing apparatus in which gas is delivered to a patient under pressure intermittently. Air or oxygen delivered into a venturi tube includes an adjustable nozzle for changing pressure as required for a particular patient&#39;&#39;s demand.

llile ales 11 Glenn [451 Apr.4,1972

[54] ADJUSTABLE PRESSURE IPPB VENTKLATOR [72] Inventor: Joseph G. Glenn,1523 S. Delaware Place,

Tulsa, Okla. 74104 [22] Filed: Aug. 20, 1970 [21] Appl, No. 65,602

' Related US. Application Data [62] Continuation-impart of Ser. No.736.173. June 11.

1968. Pat. No. 3.581.742

[52] US. Cl ..l28/145.6, 128/194 [51] Int. Cl i ..A6lm 15/00, A62b 7/02[58] Field ol'Search ..128/145.6,145.5, 145.7,1458, 128/145 R, 28,194,201, 203, 208, 185; 137/102,

[56] References Cited UNITED STATES PATENTS 2,678,044 5/1954 Szekely eta1.. ..128/194 2,918,917 12/1959 Emerson .128/145.6 3,301,255 1/1967Thompson 128/194 3,537,448 11/1970 Liston 1 28/1455 3,580,249 5/1971Takaoka ..128/l94 Primary Examiner-Richard A. Gaudet AssistantExaminer-J. B. Mitchell Attorney-Head & Johnson [57] 1 ABSTRACT Abreathing apparatus in which gas is delivered to a patient underpressure intermittently. Air or oxygen delivered into a venturi tubeincludes an adjustable nozzle for changing pressure as required for aparticular patients demand.

8 Claims, 3 Drawing Figures COMPRESSOR Pafiented April 4, 1972 3&337

2 Sheets-Sheet l COMPRESSOR I l/VVETOR. I ll JOSEPH e. GLENN ATTORNEYS 2Sheets-5h t Patented April 4, 1972 7: m& we o R 6528 $258 J. m2; mm vm3% mm wm mm w wmwma ww wm vw a 1 QM mm .ll I H m mm I h. 3 '8l/VVE/VTOR. JOSEPH 3. GLENN BY I b a W;

ATTORNEYS CROSS REFERENCES TO RELATED APPLICATIONS This application is acontinuation-in-part upon the teachings of copending application Ser.No. 736,173 filed June 11, l968,and now US. Pat. No. 3,581,742.

BACKGROUND OF THE INVENTION This invention relates to and includes thesubject matter of the aforesaid application which is incorporated byreference without repeating same. This invention like the copendingapplication relates to apparatus for treating respiratory ailments ofpatients such as chronic pulmonary emphysema, chronic bronchitis,bronchitis, asthma and others. Many, if not all, of the prior devicesincorporate a venturi tube in which an injector nozzle directs a streamof air. Such a device uses Bernoullis principle to entrain atmosphericair and deliver same to a patient at a rate of flow higher than thebasic source to the nozzle. Such a source being a compressor or highpressure contained gas source. Flow through the nozzle creates apressure differential relative to the sides of the venturi tube whichentrains additional air. As pressure rises downstream of the venturichamber, i.e., in the patients upper airway, the pressure differentialbecomes reduced along with How rate. This principle, which has provenuseful in treating respiratory diseases, is designed to reduce the workof breathing by delivering air and medication via a nebulizer into thelungs under mild pressure.

Prior to this invention limits of pressure to the patients lungs have,been a function of limiting the input pressure delivered to theinjector which directs a stream of air into the venturi. In someinstances regulators have been used to change or limit the pressure.However, such prior art devices are cumbersome and provide no means ofchanging pressure into the venturi from a constant inlet pressuresource.

SUMMARY This invention has for its primary purposes and objects toovercome problems associated with known prior art devices and to providean intermittent positive pressure breathing (IPPB) device which permitsindependent adjustment and control over the patients inspiratory flowpressure and flow rate in accordance with his needs and condition. Thisis accomplished by varying the position of the injector nozzle relativeto an orifice or throat or venturi tube without making changes in theinlet pressure. As such, changes in downstream pressure are delivered tothe patient without a great deal of variation in the maximum flow rateand without effecting the rate of nebulization. Further, by using aconstant inlet pressure the compressor, which is supplying the sourcegas, is not subjected to excessive pressure load, Further, there is noneed for regulation or adjustment of the inlet pressure. TI-Ie positionof the injector nozzle is adjusted to calibrated ranges of pressurenormally prescribed by physicians for therapy. The nozzle may be lockedin a desired position by a thumbscrew yet may be removed for cleaningand/or replacement. As a result the pressure delivered to the patientsupper airway is substantially predictable based on the position of thenozzle.

A further object of this invention is to provide an automatic or demandvalve which is dependent upon the patients inspiratory effort whicheither supplies the inlet gas to the nozzle and patients lung system orexhaust depending upon that effort.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a partial sectional view ofthe apparatus of the invention.

DETAILED DESCRIPTION The apparatus of this invention basically includesa body portion 10 which defines the chamber 12 therein. The downstreamend of the chamber includes either an orifice or throat 13 or as shownin FIG. 3 a venturi. Slidably received therein is the movable manifold14 which includes the nozzle 16 at the forward end and connects with theair or gas inlet conduit 18 at the rearward end. A finger coverableexhaust 20 interconnects with the conduit 18. Slot 21 permits movementof exhaust 20 therein. The manifold 14 further includes a threaded shaft22 extending from the body 10 through slot 23. Lock nut 24 retains themanifold 14 and hence nozzle 16 in a variety of positions relative tothe chamber 12 and throat 13. The outlet from the chamber connects withnebulizer generally designated by numeral 36. The upstream end of inletconduit 18 includes means for attaching conduit 28 which is ultimatelyconnected to a compressor 30 (diagrammatically shown) or other gaspressure source such as an oxygen tank. An inlet connector 32, ifneeded, is adapted to bleed a portion of the air or gas within conduit18 into flexible conduit 34 to nebulize medicament. The nebulizertypically includes a mouthpiece 38 for a patient. The nebulizer may beof any of those readily available such as that sold under the trademarkVaponefrin.

The adjustable nozzle body 14 further includes a plurality ofcircumferentially spaced openings 40 which are best shown in FIG. 2.

In typical operation gas (air) from compressor 30 or from a pressurizedoxygen supply is supplied to tubing 28 of conduit 18 of the adjustablemanifold 14. Gas exiting from the forward end of nozzle 16 enters theventuri chamber 12 drawing in further air flow through openings 40. Theultimate flow of air then moves downstream through throat 42 through thenebulizer and mouthpiece to the patient. The patient is advised to coverexhaust port 20 by a finger at the same time inhaling gently through themouthpiece. Once stopped, the patient is advised to continue flow for 2to 4 seconds to allow air and medication to be delivered into the lungs.Thereafter the finger is removed from port 20 and the patient exhales.By varying the location of the adjustable manifold 14 variations andultimate downstream flow pressures to the patient are achieved. That is,when the nozzle is positioned upstream or to the right in the viewshown, higher pressures, e.g., 25 cm. are capable of being supplied tothe patient whereas at the other extreme to the left on the drawing 10cm. pressure is provided. Suitable indicia on the body 10 or means maybe provided for the various settings. The range above given covers amajority of pressures prescribed by physicians for patients using IPPBtherapy. The thumbscrew 24 is used for locking the position of theadjustable nozzle. A further advantage of this apparatus is that by theaction of the manual or the automatic demand valve type the compressoris under no load whatsoever which usually increases its life expectancy.

In some instances the valve of this invention can be used as aresuscitator which in many instances requires a higher pressure range.

Some advantages to the manual or finger control valve allow the patientto be easily trained to inhale gently, stop for a few seconds, thenexhale slowly. With this, the patient can control inspiratory timewithout basically changing the pressure delivered to the other airway.Hence, the patients lungs need not be subjected to excessively highpressure to accomplish proper ventilation. A further advantage of thissystem is that the pressure required ,to operate the nebulizer is no waydecreased as would occur with changes in the compressor input.

Referring now to FIG. 3 an automatic system is depicted. As such themanual exhaust flow port 20 is closed or omitted from the constructionof adjustable manifold 14, and an opening 50 is provided to providemonitor pressure downstream of the venturi. Pressure gauge 52 isattached thereto via conduit 54. The gauge includes adjustableelectrical low pressure contact 56 and high pressure contact 58 whichmakes electrical contact with indicator hand 60. Electricity (110 AC issupplied to a control circuit 62 which, among other things, reducesvoltage to a low control voltage, e.g., 24 volts to the pressure gaugecontacts. From the pressure gauge electrical leads 64 function toactuate solenoid valve 66. The valve is normally open to exhaust whenused with a compressor otherwise it is normally closed. A timer control68, which is adjustable using knob 70, is electrically attached to leads64. Oxygen or air under pressure is regulated at 72, if necessary, to alower pressure and caused to travel through valve 66, being normallyopen, to exhaust.

The schematic diagram of FIG. 3 shows the various means to achieve timedcontrol of inspiratory time to the patient. In one embodiment the timethe valve 66 is open to flow gas to the nozzle 16 is a function of theadjustable setting of contacts 56 and 58. In another embodiment timecontroller 68 is actuated by the initial inspiratory low pressure toclose contact 56. The timer is set to add a slight additional flow for afew seconds to the patient even though his normal inhalation has ceased.This added time fills ailing lungs with air and medicament beyond whichthat the patient can do.

An advantage of this embodiment is that it is isolated from thebreathing circuit so that the control console is not subject to anycross-contamination between patients in addition to the complete controland adjustment to a particular patients demands and capabilities.

The invention above described should be understood as not limited in itsapplication to details of construction and arrangement of partsillustrated in the accompanying drawings, since the invention is capableof other embodiments and of being practiced or carried out in variousways. Also it is to be understood that the phraseology or terminologyemployed herein is for the purpose ofdescription and not oflimitation.

What is claimed:

1. Apparatus for IPPB therapy comprising:

a body portion defining therein a gas flow passage chamber and adownstream orifice;

a mouthpiece attached downstream of said orifice;

a manifold received within said chamber and slidable therein toward andsway from said orifice, said manifold including a nozzle at its forwardend directed toward the center ofsaid orifice;

an inlet conduit providing communication with said nozzle and a pressuregas source;

an exhaust conduit and port in communication with said inlet conduitrearwardly of said nozzle, and

a plurality of circumferentially spaced openings in said manifoldproviding communication from the atmosphere to said chamber.

2. Apparatus of claim 1 including means to retain said manifold andnozzle in a desired axial position relative to said orifice.

3. Apparatus of claim 1 including a medicament nebulizer between saidmouthpiece and said outlet passageway, and

a conduit to supply said gas from said inlet conduit to said nebulizer.

4. Apparatus of claim 1 wherein said orifice is a venturi.

5. Apparatus for IPPB therapy comprising:

a body portion defining therein a gas flow passageway chamber and adownstream orifice;

a mouthpiece attached downstream of said orifice;

a manifold received within said chamber and slidable therein toward andaway from said orifice said manifold including:

a nozzle at its forward end directed toward the center of said orifice;

an inlet conduit providing communication with said nozzle and a pressuregas source;

a plurality of circumferentially spaced openings in said manifold toprovide communication from the atmosphere to said chamber; anelectrically timed means to control flow of said gas to said inletconduit including:

means to sense the pressure of said gas downstream of said orifice;

means responsive to said pressure sensing means to activate anelectrical circuit at a first pressure and deactivate said circuit at asecond higher pressure; and

valve means responsive to said electrical circuit at said first pressureto cause the flow ofsaid gas to said inlet conduit and response at saidsecond pressure to stop the flow of said gas to said inlet.

6. Apparatus of claim 5 wherein said means responsive to said pressureactivates a timer which controls said valve and the flow ofsaid gas fora desired period.

7. Apparatus ofclaim 5 wherein said orifice is a venturi.

8. Apparatus of claim 5 wherein said means responsive to said pressureis adjustable to a desired first pressure and a desired second pressure.

1. Apparatus for IPPB therapy comprising: a body portion definingtherein a gas flow passage chamber and a downstream orifice; amouthpiece attached downstream of said orifice; a manifold receivedwithin said chamber and slidable therein toward and sway from saidorifice, said manifold including a nozzle at its forward end directedtoward the center of said orifice; an inlet conduit providingcommunication with said nozzle and a pressure gas source; an exhaustconduit and port in communication with said inlet conduit rearwardly ofsaid nozzle, and a plurality of circumferentially spaced openings insaid manifold providing communication from the atmosphere to saidchamber.
 2. Apparatus of claim 1 including means to retain said manifoldand nozzle in a desired axial position relative to said orifice. 3.Apparatus of claim 1 including a medicament nebulizer between saidmouthpiece and said outlet passageway, and a conduit to supply said gasfrom said inlet conduit to said nebulizer.
 4. Apparatus of claim 1wherein said orifice is a venturi.
 5. Apparatus for IPPB therapycomprising: a body portion defining therein a gas flow passagEwaychamber and a downstream orifice; a mouthpiece attached downstream ofsaid orifice; a manifold received within said chamber and slidabletherein toward and away from said orifice said manifold including: anozzle at its forward end directed toward the center of said orifice; aninlet conduit providing communication with said nozzle and a pressuregas source; a plurality of circumferentially spaced openings in saidmanifold to provide communication from the atmosphere to said chamber;an electrically timed means to control flow of said gas to said inletconduit including: means to sense the pressure of said gas downstream ofsaid orifice; means responsive to said pressure sensing means toactivate an electrical circuit at a first pressure and deactivate saidcircuit at a second higher pressure; and valve means responsive to saidelectrical circuit at said first pressure to cause the flow of said gasto said inlet conduit and response at said second pressure to stop theflow of said gas to said inlet.
 6. Apparatus of claim 5 wherein saidmeans responsive to said pressure activates a timer which controls saidvalve and the flow of said gas for a desired period.
 7. Apparatus ofclaim 5 wherein said orifice is a venturi.
 8. Apparatus of claim 5wherein said means responsive to said pressure is adjustable to adesired first pressure and a desired second pressure.